By Elaine Zhu
One of my favorite Disney movies as a child was Finding Nemo--I loved Dory’s jokes and Marlin’s quest to find Nemo. But what made the movie so memorable were all the beautiful colors and structures of the coral reef where the main characters lived.
Imagine my shock when I found out that the Great Barrier Reef — the world’s largest coral reef system and the home of Nemo, Marlin, and all the other marine animals in Finding Nemo— was pronounced “dying” and given an obituaryby Outside Magazine. In 2017, Naturealso published an article demonstrating that large stretches of the Great Barrier Reef’s northern region were declining.
Coral reefs are not just beautiful spectacles for humans to enjoy, but they are also an essential part of our oceans, ecosystems, and economies. For example, they are important spawning and feeding grounds for a plethora of marine species and support over 4,000 fish species. They also provide buffers from strong currents or waves and natural protection for vulnerable coastlines. According to the NOAANational Marine Fisheries Service, coral reefs provide over $100 million in commercial value for United States fisheries. In total, the Hopkins Marine Station of Stanford Universityestimates that the coral reefs bring in around $30 billion in economic benefit from tourism, fishery, and food industries.
In order to understand why coral reefs are dying, we need to examine the internal structures of coral. The coral species are divided into hard and soft coral. Hard coral builds the foundation of reefs, using the calcium carbonate found in the ocean water to create a strong exoskeleton. On the other hand, soft coral does not have a skeleton and looks similar to trees and other plants, bending to the currents in the ocean. Soft coral also provides a habitat for fish, snails, and other sea organisms as well as protects the shore from wave activity.
In reality, while we often use the umbrella term “coral” to describe the reefs and related structures, the coral species is actually made up of individual organisms called “coral polyps,” which are tiny invertebrates related to anemones and jellyfish. These polyps attach themselves to hard surfaces on the seafloor and reproduce to form thousands of clones, eventually becoming a coral colony. As these colonies grow, they connect to other coral colonies to form the large expanses of coral reefs we see today.
While coral reefs on the whole are declining, coral itself does not immediately die off and wither away. It first goes through a process called coral bleaching. Coral gains nutrients from microscopic algae cells, called zooxanthellae, that live inside the coral polyps. Zooxanthellae use photosynthesis to convert sunlight into usable energy, which directly benefits the coral housing of these cells. When the zooxanthellae are exposed to different stressors, such as extended periods of high temperatures, they release oxygen-free radicals, which can cause cell membranes to decay and which are dangerous to the coral’s health. This causes the coral polyps to eject the algae cells, which causes the remaining coral to turn almost completely white, since the algae provides the pigment to the coral. Because the algae cells give the coral its essential nutrients, this ejection also leaves the coral vulnerable, and, oftentimes, the coral ends up dying. Ultimately, though, coral bleaching does not necessarily mean the coral is dead—the coral can often actually recover from these bleaching events. Recently, scientists found that the time between these bleaching events is shortening, leaving an inadequate amount of time for the coral to recover.
So what is causing the decline of coral reefs? In recent years, global warming has been creating increasing amounts of stressors for the coral. Specifically, because of increased amounts of greenhouse gases due to human activity, ocean temperatures and sea levels are rising, storm activity and hurricanes are changing, and the ocean is acidifying—all of which negatively affect coral reef ecosystems. These stressors not only cause increased amounts of coral bleaching but can also lead to the smothering or destruction of coral reef systems and decrease coral growth. As a result, coral reefs have been struggling to keep up. In fact, a recent 2019Naturearticlefound that “the amount of larval recruitment declined in 2018 by 89% compared to historical levels” due to “unprecedented back-to-back mass bleaching events caused by global warming.”
Coral reefs have existed on Earth much longer than humans have inhabited this planet, yet they are facing mass bleaching and death due to human activities. Changing our actions could stop further harm to the coral reefs. The Australian government has already set forth a “Reef 2050 Long-Term Sustainability Plan,” which provides a plan of action for reducing human actions that damage coral. Some of its proposed actions include reducing the pollution of ports and agriculture into the Great Barrier Reef, and placing protection on sea turtles and animals through new policies against poaching. While this sustainability plan is a step in the right direction, everyone can protect coral reefs in their own way. For example, by conserving water, choosing sustainable seafood, and reducing our individual carbon footprint, we can all make a difference in protecting coral reefs. If we reduce greenhouse emissions and slow down global warming, we may be able to halt the quickening process of coral bleaching in its tracks and save the home of Marlin, Dory, and Nemo.
By Liza Casella
You probably think of yourself as a single organism—humans are notorious for our human-centric way of seeing the world. But you wouldn’t be the same without your microbiome. The word “microbiome” has recently become a buzzword in the scientific community, and for good reason. The term refers to the trillions of bacteria that have a symbiotic relationship with their host. While bacteria inhabit nearly every organ in our body, the vast majority of these microorganisms live in our large intestine. It has been known, for many years, that the gut microbiome is necessary for proper digestion, nutrient uptake, and regulation of the immune system. Recent studies, however, have suggested that the microbiome is involved in the development of mental illnesses, as well.
The brain and intestines communicate through the gut-brain axis, the bidirectional system of communication between the central nervous system and various microorganisms (such as intestinal bacteria, viruses, and unicellular eukaryotes). Intestinal microbes release various hormones, neurotransmitters, and chemicals associated with the immune system. These molecules travel through blood vessels, sending signals to the brain that affect the concentrations of cortisol, dopamine, serotonin, and other neurotransmitters in the blood. While details of the specific mechanisms underlying the gut-brain axis are still unclear, researchers have hypothesized that when the brain experiences emotional stress, intestinal permeability is affected. This leads to not only a reduction in the body’s uptake of nutrients but also to changes in the signaling activity of intestinal bacteria.
While the discovery of antibiotics, antiseptics, and on the most basic level, soap, in the past few decades has improved general hygiene, it has also led to an unforeseen negative consequence on the microbiome population. These developments have diminished the number of bacteria we come into contact with, reducing the diversity of our intestinal microbiomes. The Hygiene Hypothesis theorizes that this disruption of our microbiomes causes many health conditions such as inflammatory diseases, which were once prevented by intestinal microbes that would in turn activate certain genes for the benefit of human health.
The link between emotions and the microbiomeis clear; when an individual experiences profound stress or sadness, their cells secrete inflammatory cytokines, small molecules that cause an inflammatory response. The process starts in the gut when intestinal microbes interact with receptors on immune cells, triggering an immune response. Then, these microorganisms in the gastrointestinal tract produce neuroactive substances like neurotransmitters which act via the gut-brain axis to affect the central nervous system. Now, researchers have begun testing whether this connection can be extended to potential treatments for mental illnesses such as depression. Depressive disorders are some of the most common mental illnesses, affecting 16.2 million adultsin the United States in 2016, primarily between the ages of 18 and 24. Antidepressant medications are currently the most common treatment for these illnesses. Some antidepressants work by increasing the production of immunomodulatory cytokines, which block inflammatory cytokines that cause depression.
Interestingly, similar to antidepressant medications, intestinal bacteria can also elicit the production of immunomodulatory cytokines that travel through the bloodstream and modulate the inflammatory response. However, few studies have been conducted to test the effects of probiotics, or bacteria that we know are beneficial to the microbiome, on alleviating symptoms of depression. A 2015 studyfound that a multispecies probiotic had a significant effect on improving mood and decreasing aggressive thoughts in a sample of people without current mood disorder diagnosis. While this is an important finding, it does not tell us if probiotics will have the same effect in people with mood disorders. For instance, a 2018 meta-analysisof studies found that probiotic use had an insignificant effect on mood but was limited by the fact that different trials used a variety of different probiotics. Far fewer studies have been conducted using participants who have clinically diagnosed depression or other mood disorders.
Unfortunately, this limits the extent to which findings demonstrate the effect of probiotics on the mental health of people with mood disorders. Studies should be designed to yield more applicable potential treatments for depression and other mood disorders, which will require including people with mood disorder diagnoses. Because microbiome health may be linked to a variety of mental illnesses, it is important to determine how and if microbes affect brain function, and if probiotics can offer a new treatment option for depression and other mental health disorders.
We as humans live in symbiosis with our intestinal bacteria. Our health affects theirs and vice versa. Understanding the mechanism by which microbiome health is linked to not only physical but mental health is critical to understanding how mental illnesses arise and develop and to finding an effective treatment.
By Liza Casella
Psychedelic mushrooms, colloquially known as magic mushrooms or shrooms, have a long and complicated history. While people used them in religious and cultural rituals for centuries, these mushrooms only caught the attention of the scientific community during the mid-twentieth century. Accordingly, scientific efforts began to investigate the effects of various psychedelics on the human mind. Psychedelic mushrooms also appealed to the general population, leading the era’s overzealous administration to classify them in 1971 as a Schedule I Drug — one that has “high potential for abuse and the potential to create severe psychological and/or physical dependence…[with] no accepted medical use.” This classification, however, may be erroneous.
Psilocybe cubensis is the most common member of the family of psilocybin-producing mushrooms. Psilocybin is the compound responsible for the “trip” that follows the ingestion of psychedelic mushrooms, which belong to the drug class of hallucinogens. Inside the body, psilocybin is chemically converted to psilocin, an active agent within the central nervous system. Psilocybin is structurally similar to serotonin and, once converted to psilocin, it serves as a partial agonist for serotonin receptors by acting like serotonin and affecting the serotonergic transmission system, which regulates one’s mood. Moreover, while psilocybin does not interact with dopamine receptors directly, it leads to downstream effects that increase the amount of dopamine in the basal ganglia, the area of the brain responsible for motor control, behavior, and emotion. Ultimately though, the exact pathways through which psilocybin affects the brain are still being elucidated.
Furthermore, the effects of psychedelic mushrooms vary depending not only on the species and amount, but also the person ingesting them and the setting in which they are ingested. After consumption, people may experience euphoria, epiphany, visual effects, distorted perception of time, giddiness, dissociation, disorientation, and elevated energy. On the other hand, they may also experience anxiety, panic, and sadness, which are considered characteristics of a “bad trip.”
In the past decade, there has been a resurgence in research involving psychedelics, primarily for their potential in treating psychiatric illnesses. Psychedelic therapy was first studied in the mid-twentieth century before the government criminalized psychedelics and placed stringent restrictions on their use in a research capacity. Now that attitudes toward psychedelics and the necessity of drug criminalization have brought on new reforms, researchers have begun testing again if psilocybin has therapeutic potential.
In 2015, astudycategorized alcohol use disorder (AUD) as the most prevalent substance use disorder in the United States though treatment options for patients are still very limited. Despite its ubiquity, Alcoholics Anonymous has a hypothesized success rate of between 3% and 8%. While these statistics have been heavily contested and the premise of Alcoholics Anonymous makes it impossible to track participants’ sobriety, it nonetheless remains that many people are still without effective treatment. This is where psilocybin comes in.
Pilot studies testing psilocybin therapy for AUD have demonstrated positive results. During one such study, ten participants with AUD each underwent twelve therapy sessions in a living room-like environment and received psilocybin after the fourth and eighth sessions. After ingesting the psilocybin in capsule form, participants were instructed to lie on a couch wearing eye shades and headphones. They listened to music and were instructed to concentrate on their thoughts and feelings while under the influence of psilocybin.
Interestingly, the study demonstrated that both the number of drinking days and heavy drinking days for all the participants decreased throughout the experiment. While this study had a limited sample size, other similar studies have found corroborating results apropos the reduction of substance use and cravings in patients with substance use disorders after treatment with psilocybin.
Psychedelic therapy is a promising method of treatment for substance use disorders as well as other psychiatric illnesses. Despite what the government’s archaic and flawed drug classification system says, psilocybin has been shown to be non-habit forming, non-addictive, and quite safe to use for people who desperately need novel treatment approaches. It’s possible that it could be used in the treatment of other substance use disorders with fewer side effects than current treatments. Psilocybin-assisted treatment for AUD holds significant potential and should be tested more thoroughly to determine effective guidelines for its administration.
By Anna Christou
Influenza, commonly known as the flu, is a virus that infects the nose and throat and can lead to sore throat, fever, fatigue, and coughs. The flu is highly contagious and can be spread through the air from sneezing or coughing, or from touching infected surfaces. Each year, 5-20%of Americans contract the flu, leading to 31.4 million outpatient visits and 200,000 hospitalizations annually. Although the flu resolves on its own for most, high-risk patients, such as young children, old adults, or people with chronic illnesses and weakened immune systems, can develop potentially fatal complications, such as pneumonia, bronchitis, or heart problems. The annual flu vaccine is 40-60% effective because it only protects against some strains of the virus, while antiviral medications that reduce the harmful effects of the flu can only treat the illness—not prevent its onset. Therefore, researchers have begun to investigate broadly-neutralizing antibodies as a way to target a wide variety of flu strains at once. Notably, a group of researchers published astudy in Science this past March, outlining their discovery of a pill that can prevent multiple strains of the flu in mice.
The Centers for Disease Control and Prevention recommendsthe flu vaccine as a way to protect against the harmful effects of influenza: it can prevent contraction of the virus and, if individuals do become sick, vaccination reduces the severity of their illness. However, the flu vaccine only targets a few specific strains, while new strains continue to emerge. In addition to the vaccine, antiviral drugs, such as Relenza and Tamiflu, can be used to fight the infection and reduce symptoms. One way that antiviral drugs work is by preventing the virus-infected cell from releasing its viral progeny, which could go on to infect other healthy cells. However, these treatments are still not preventive, and reliable prevention techniques still need to be developed. In addition, viruses can develop resistance to antiviral drugs, thus, it becomes even more imperative to develop new methods of combating the flu.
Neutralizing antibodies, naturally present in the body, are now being used to prevent the flu. Neutralizing antibodies are carried by immune cells and block the proteins viruses use to invade target cells. Specifically, the antibodies bind to antigens, which are markers of the virus. This renders the virus inactive, since it is now unable to attack and infect host cells. Not all viruses can be inactivated through this approach, since a neutralizing antibody can only bind to specific antigens; however, there are broadly-neutralizing antibodies, which can simultaneously impede a wide variety of virus strains and are, thus, more effective.
The fact that influenza-specific, broadly-neutralizing antibodies can be used as a preventive drug is already known. Accordingly, broadly-neutralizing antibodies target the hemagglutinin (HA) stem of the influenza virus, the part of the virus that allows it to enter a host. Since antibodies are large proteins and are difficult to deliver orally, it is necessary to develop smaller molecules in order for this technique to have realistic, practical applications.
The researchers who published the aforementioned Science study screened a chemical library to find a small compound that would mimic broadly-neutralizing antibodies and also target the HA stem of the virus. Through in vitro studies, they found that a chemical compound called JNJ7918 could bind effectively to the HA stem and neutralize the influenza virus. The HA stem normally undergoes a conformational change that then triggers the virus to release its genome into the host cell, allowing the virus to reproduce and take over the host. However, JNJ7918 blocks HA and consequently prevents the virus from injecting its genome into the host.
The researchers further modified this compound to allow it to bind and neutralize the flu virus more specifically and efficiently. The remodeled compound, named JNJ4796, is more soluble in water and has a lower intrinsic clearance. Intrinsic clearance measures how quickly the liver can metabolize a drug, so a drug with a lower clearance stays active in the body longer. The authors of the paper indicated that increased solubility and lower intrinsic clearance makes this compound more suitable as a drug than JNJ7918.
JNJ4796 was also found to bind to and neutralize influenza in vitro, and could protect mice from influenza if administered orally. Since influenza primarily affects the respiratory system, the researchers investigated whether the drug could prevent the flu specifically within the lungs: they found that JNJ4796 could indeed neutralize the influenza infection in bronchial cell cultures.
This finding presents a promising method of preventing the flu that can target and attack a broader range of influenza strains. In addition, the development of a small orally-active molecule that mimics a naturally-occurring antibody opens up the possibility of using antibodies as therapies for other diseases, including various types of cancer, rheumatoid arthritis, and multiple sclerosis.
Despite this impressive discovery, numerous challenges still exist. Although employing broadly-neutralizing antibodies to fight the flu would allow for more strains of the virus to be targeted, resistance could still emerge. Over time, viruses can develop mutations that confer resistance against these antibodies. Resistant mutants, can then use their selective advantage to infect a larger portion of the population. Nevertheless, the advent of broadly-neutralizing antibodies allows for numerous promising possibilities in flu therapy.
By Hannah Prensky, Illustration by Audrey Oh
The launching of the Sputnik satellite. The race for space. Laika, the first traveler into the Cosmos. Shepard bringing the American flag into orbit. Since the 1950s, the Cold War propelled generations of astronauts and astronomers to delve deeper into the dark unknown, using rockets fueled by the desire to go further. In the years following Sputnik, the American space agency, NASA, aligned a series of missions like a syzygy of planets in space. During the sixty years since the first venture into the final frontier, human knowledge of space has expanded like the universe during the Big Bang. Now, not only are we sending satellites to look deeper into space; we are sending robots to physically explore other planets.
When the Opportunityrover took off for Mars in 2003, the Mars Science Laboratory at NASA aimed to answer some of mankind’s most profound questions. It touched down on the Martian surface with the primary mission of determining whether Mars is, was, or ever will be suitable for life. Opportunity was primarily searching for recoverable water, which is the main indicator of a planet’s potential to sustain life. Water manifests in geological samples that could have been formed from minerals deposited in water-related events, including precipitation, erosion, and sedimentary cementation. Life, as we know it, depends on liquid water for survival; thus, finding water on Mars would be a vital step toward the groundbreaking discovery of life on the Red Planet.
Opportunity explored craters, hills, and valleys for an astounding fourteen years. The rover unearthed indications of water through environmental, chemical, and mineralogical analyses of the Red Planet. One piece of evidence supporting the hypothesis that water once saturated Mars arose in the form of small, evenly distributed spherules of the mineral, hematite, on a Martian plain. On Earth, hematite is often formed in areas where hot springs or pools of water flow, which lead scientists to believe the hematite spherules on Mars remained from ancient sources of water. Data and images from Opportunity confirmed that a large body of water once covered the plain. Scientists at NASA are now using clues like these to search for ancient life.
On February 13, 2019, NASA declared the Opportunity Mars rover obsolete after almost eight months of silence following a raging sand storm on the surface of the Red Planet. The Martian sand blocked Opportunity’s solar panels, hindering its ability to generate power. NASA lost communications with Opportunity on June 10th, 2018, but scientists remained hopeful that they would regain a signal after the storm subsided in the autumn. Unfortunately, after sending thousands of recovery commands with no response from the record-breaking rover, NASA officially declared the completion of the Opportunity mission in February. The final transmission sent to Opportunity before the mission ended was the song, “I’ll be Seeing You,” by Billie Holiday, delivered to Mars’s Perseverance Valley.
Although Opportunity was initially launched from Earth for a planned 90-day mission, it defied all odds and continued to explore for a decade and a half. Since the advent of galactic expeditions in the Cold War era, discoveries and breakthroughs have occurred at a rate few in the 1950s would have thought possible. Despite having sent satellites, animals, humans, and rovers into space, our space achievements are far from over. The hope and progress Opportunity provided to space exploration expanded our curiosity, and offered a unique perspective on humanity’s place in the universe. But more importantly, Opportunity gave us further insight into some of mankind’s most profound questions: What is the nature of life in the universe and does it exist elsewhere? Are we and our planet unique?
Humankind has never been satisfied with what we already know. The need to discover more is ever-present. Over time, civilizations have traveled to different colonies, countries, and now, planets. While helping to revive our curiosity for celestial enterprises, projects like the Opportunity rover demonstrate the elegance and elusiveness of the evolving universe. We have no final answers to our age-old questions; the search continues.
By Ashley Sun and Sirena Khanna
It’s time for your annual check-up. As you enter the doctor’s office you are greeted by the receptionist at the door. Just like last year, you begin your visit with a health questionnaire. You’re happy to discover that this time the survey is given to you on a tablet with a Google Form—no more painful scribbling against a crusty clipboard. You start scrolling through the questions. In the last year, were you or anyone in your family admitted for an overnight stay in a hospital? “No.” Have you ever been diagnosed, treated, medicated, and/or monitored for X, Y, and Z diseases? “No, no, and I have no clue what that is.” You mindlessly tap away at the endless survey, which is still as much a bore as the paper version.
At the end, you notice an odd question: do you consent to letting artificial intelligence (AI) use information contained in this survey to better assess patient healthcare? You aren’t quite sure what this means, so you walk up to the receptionist whose bright blue eyes flicker on as you approach. “How may I help you?” it automatically asks. You glance at the name tag. “Hey, NurseBot Janet, can you explain this last question to me?” The robot promptly explains that data from these surveys will be privately stored in your Electronic Health Record and will allow AI to help your physician make a personalized plan for your health. Considering that you have nothing to hide about your health, you consent and press “Submit.” Thank you for your response!
NurseBot Janet is not far from the future. In fact, engineers in Japan have alreadydesigned robots like nurse bear and Paroto care for elderly patients by conducting a range of activities, from lifting them off beds to engaging in simple conversation. The potential for artificial intelligence (AI) in the healthcare industry is as vast as your imagination. Dozens of start-ups around the world have created a buzzing field of medical AI. As of now, AI companies have focused on data storage (Google Deepmind Health), crowdsourcing data for research (Atomwise, IBM WatsonPaths), predictive analytics (CloudMedX Health), hospital management (Olive), medical imaging (Arterys, VoxelCloud, Infervision), and personalized care (Bio Beats, CareSkore, Freenome, Zephyr Health). AI has proven to be much better than humans at mining medical records, assessing the success of different treatment options, and analyzing medical scans. With the future of medical AI like Nursebot Janet on the rise, is the healthcare industry going to experience an AI apocalypse,as foretold by Elon Musk?
The AI apocalypse may have already begun in your own smartphone. The current market for health-related applications consists of around a quarter million health apps, each of which are relatively sophisticated. These apps often extend far beyond basic diagnostic searches, and include the use of personalized information such as photographs of skin lesions for the detection of melanoma. The sheer detail and convenience that these apps provide have driven consumer demand to new levels. According to a report by Accenture, health app downloads and wearable technology usage have tripled and quadrupled, respectively, in the past four years. The expectations for these tools to deliver high-quality information and care has increased accordingly, as user experience has become a major priority in such apps.
With these developments, new issues are emerging concerning the information provided through AI. Studies have been conducted regarding the diagnostic accuracy of apps that focus on melanomas, in particular, and have raised serious questions about the quality of medical information for cancer risks. There are tangible legal and ethical consequencesregarding life-threatening mistakes and how responsibility should be assigned with AI-generated diagnoses. Questions of trust are also being considered, specifically concerning the privacy and security of personal, medical informationbeing stored by private companies. In dealing with these issues, the FDAhas, nevertheless, determined that apps used for diagnosis, treatment, or prevention of disease pose a low risk to the public; as a result, there is minimal regulation at odds with the obvious need for management on health advice that may not always be evidence-based.
Ultimately, the main bioethical issues of individualized care, provided through AI-based health apps, are those of accountability, confidentiality, trust, accuracy, and comprehensiveness. Who is accountable for the information provided to the patient? Can you trust an AI company to give you the best health advice? In order to avoid these particular bioethical issues, it may be best for AI health apps to be made specifically for physician use rather than widespread commercial use.
Say goodbye to NurseBot Janet. Welcome your living, breathing, human physician. Although smartphone apps may be a great way to empower the patient and give them autonomy over their health, physician-mediated AI use would avoid a multitude of legal and bioethical issues associated with health apps, such as those of regulation and accuracy.
How should AI be used as a tool by physicians to personalize patient healthcare? When patients interact with AI apps that are also connected to healthcare providers, their data and a machine-generated diagnosis can be sent to a responsible physician, who would then make the final decisions regarding actual medical care. When many of these patient-AI-physician relationships occur at the same time, the machine learning aspects of AI in apps would augment their decision-making accuracy, which would be repeatedly confirmed by medical professionals, as well. This system would mimic organizations like Human Dxand Figure 1, which are crowdsourcing platforms that rely on solutions proposed by a range of healthcare professionals to solve ambiguous cases. A greater reliance on the opinions of multiple physicians would mitigate inaccurate or overly cautious AI-based recommendations and would aggregate symptoms to create reliable banks of data for future diagnoses. The combined knowledge of physicians and AI will curate more healthcare optionsthat are personalized for the patient. It will also maintain the emotional and humanizing aspect of care in the direct physician-patient relationship.
With this paradigm, the physician can ensure personalized healthcare while avoiding the slippery slope of patients self-diagnosing with misinformation. The physician’s involvement also guarantees a level of confidentiality and legal responsibility that currently unregulated health apps do not afford. For example, technologies like Apple’s single-lead ECG featureon their Apple Watch allows the user to print PDFs of their results to share with their physician. AI companies should model their product development under this physician-mediated model, like ADA does, to ensure the most bioethical product.
For those skeptical of AI healthcare, rest assured that human doctors will not be replaced by robot clinicians anytime soon. Instead of NurseBot Janet, it’s more probable that you encounter NurseApp Janet, an online smartphone app that stores biometric information and surveys your health for your real-life physician to check each year. Luckily, you agreed to Janet collecting your health information, so the next time you come for your check-up, you won’t need to answer the boring and generic patient questionnaire. Through the app, AI has gathered the answers to these questions, while your healthcare provider has consulted with a crowd-sourced sharing platform to come up with accurate and comprehensive healthcare advice for your mysterious disease. On your next visit to the doctor’s office, you’re glad to see that NurseBot Janet has been replaced by—you take a closer look at the nametag—Janet, a human this time. For now, the AI apocalypse can be averted by keeping humans in charge of your healthcare.
By: Hari Nanthakumar
The destruction of the hot flames was ruthless, engulfing, and destroying trees, homes, and anything else within reach.
As devastating wildfires raged through California this past year, individuals of all socioeconomic backgrounds fled their homes in the face of flames that seemed to encroach upon the very foundations of their lives. Undoubtedly, we feel sympathetic to those who have lost so much and have gone through some of the worst life has to offer.
Before we can understand exactly how wildfires affect people, we must first examine their environmental effects. Wildfires significantly worsen air pollution through particulate matter in their smoke. Particulate matter encompasses the microscopic pieces of material that fire releases, including a variety of chemical species, ash flakes, dust, and small shreds of wood. According to a reviewpublished in the Journal of Environmental Toxicology and Pharmacology (JETP), wildfires contribute up to 20% of fine particulate emissions in the United States and up to a third of all particulate emissions in Canada.
As the air fills with smog, people are forced to breathe in an inordinate number of respiratory irritants, developing harmful new health conditions. For example, a studyof the effects of the 2003 Southern California wildfires demonstrated that smoke stimulated asthma, while also causing symptoms of bronchitis, including shortness of breath and excess mucus production. The review in the JETP also revealed that, correlated with recent fires, was an increase in hospital visits for symptoms of chronic obstructive pulmonary disease, which blocks airflow and leads to dyspnea.
Even more worrying health developments stem from the smog and its particulate matter. The Environmental Protection Agency (EPA) has stated that particulate matter can affect heart and lung tissue, trigger heart attacks, decrease lung function, and even cause premature death in those with preexisting heart or lung disease. Equally ominous is the potential linkbetween the inflammation caused by particulate matter and diabetes; toxic particulate matter enters the lungs and the bloodstream, causing inflammation in the organs and leading to insulin resistance. As this inflammation builds, the pancreas may be unable to produce enough insulin in response, and allows diabetes to set in.
As smog continues to fill the air from the California wildfires, government agencies, such as the Bay Area Air Quality Management District, have warned people to stay indoors to protect themselves. The homeless, however, often have no recourse and therefore cannot always evade the harmful effects of their environment. Even without smog, they face doublethe average rate of lung disease and are already more vulnerable to illnesses such as skin disorders, diseases of the extremities, and untreated mental illnesses, which can be exacerbated under the stresses of wildfires.
As Vice News reports, the wildfires may usher in a “new wave of homelessness” as increasing numbers of people’s homes are engulfed in the fires. The newly homeless will join the ranks of people who have nowhere to go as home prices and rents continue to soar throughout the California area. A case in point is the story of the paradoxically-named town of Paradise, California. With 14% of people living below the poverty line and average household incomes well below national averages, people were forced to live in front of nearby Walmart and Lowe’s parking lots due to the destruction of 90% of residential homes and Norovirus outbreaks in at-capacity homeless shelters.
Stories like this will become all too common in the future, as climate change is projected to increase wildfire emissionsup to 101% in California through 2100 through increasing temperatures and changing precipitation patterns. The number of wildfires and acreage burned is also expected to increase across the greater western United States.
Unless significant actions are taken to protect the most vulnerable of our population, we are in serious danger of putting stress on people’s health and our societal infrastructure. Just as diseases have spread within the close quarters of homeless shelters in Paradise, similar cases may befall hospitals and other public areas as crowds of people are displaced from their homes. Whether it be an efficient way to distribute air-quality masks or provide decent shelter, something needs to be done. Absolutely no one should be left alone, fearful of the very air they breathe.
Hari Nanthakumar is a freshman in SEAS hoping to study materials science & engineering.
By: Naviya Makhija
From hives to anaphylaxis to something as simple as a passing bout of sneezes, allergies are both common and annoying. In fact, they are becoming more widespread and, more disturbingly, are beginning to manifest later in life for many. As this particular aspect becomes the focus of more research, it is becoming increasingly important to return to the fundamentals: why do allergies manifest in such a seemingly random way, and, why do they occur at all?
An allergy, often defined as a hypersensitive immune response, is simply the body’s response to stimuli that it deems harmful and thus attempts to reject. Each reaction is specific to the victim. What one person experiences in response to a specific stimuli, such as peanuts, may differ in form and extremity to another person. In fact, for most people, the stimulus may not have any impact whatsoever. The response is “random” in this sense: the immune system attacks agents that look similar to ones that it considers harmful, but it is still uncertain why it launches such attacks in the first place. New theories suggest that the reason for allergic reactions is to build up a protective system. In 1993, Margie Profet won the MacArthur Genius Grant for being the first person to postulate that allergies are a protective mechanism. In her view, anything from sneezing and watery eyes to nausea and vomiting can be considered the body’s attempt to combat toxins, pathogens, or even carcinogens. She highlighted more severe cases involving anaphylaxis, and noted that the resulting fall in blood pressure was a protective measure to slow toxin circulation through reduced blood flow.
While not fully accepted at the time of its proposal, Profet’s theory has gained traction over the years. In 2012, researchers at Cornell University discoveredthat individuals with allergies are more resistant to certain types of cancer, yet it is still not fully understood how this incorporates Profet’s own discoveries. Profet believed that, since most of the carcinogenicmaterials were also the most allergenic, the patient would naturally avoid them due to his or her allergies. Other members of the scientific community continue to dispute this, stating that the patient would have a more hyperactive immune system due to his or her allergies and thus this system would become more adept at handling infections of all types, including those leading to cancer.
Researchers at Stanford University have recently discovered that exposure to allergens, such as venom and bee stings, in mice produces a protective responsethat creates unique antibodies to counteract the original stimulus. These antibodies are memorized by the body, and should the body come into contact with that stimulus again, the reaction intensity may be diminished due to the adaptive immune response. When these same mice, initially exposed to the bee venom, were given a lethal dose three weeks later, over80 percentof them survived. This evidence indicates that the body uses allergic reactions to build up resistance to harmful threats, supporting Profet’s original postulation that allergies are fundamentally protective responses that our bodies need.
It seems ironic that the purpose of allergies is to protect the body from external harm, since they are often so severe (anaphylaxis) that they end up causing more harm themselves. When the body reacts to an allergen, it releasesImmunoglobulin E—an anti-allergen antibody—and, if it is the first interaction with the stimulus, enters a process called sensitization. During this process, the body releases organic compounds such as histaminethat manifest as common allergy symptoms or, in more dangerous cases of overreaction like anaphylaxis, hives, hypotension, airway constriction, nausea, and even fainting.
Perhaps, sensitization was a protective measure on its own, during a time of less-advanced medicine. With no other alternative, maybe the body’s only way of protecting itself was to asphyxiate itself so as to prevent further exposure to the allergen. With modern medicine, this seems unnecessary and destructive, and, while it can be said that the presence of allergies has severely declined as a consequence of medicine, it’s strange that many have withstood the test of time. Perhaps new research rooted in Profet’s original hypothesis can help find new treatments as the cause of allergies becomes clearer.
By: Anna Christou
Adenine, guanine, cytosine, and thymine—these four nitrogen-containing compounds, also known as A, G, C, and T, respectively, have been known, since the mid-twentieth century, to be the main components of DNA. DNA defines our characteristics, including how we look, behave, and grow, and the sequence of these base pairs is crucial to determining how DNA replicates and codes for protein. With the rise in genetic engineering, scientists have been able to manipulate these base pairs to change an organism’s genes, which has a variety of implications for research, creating vaccines, and developing drugs. Given the endless potential that studying four DNA base pairs affords us, it's almost impossible to comprehend what we could do with eight base pairs. But recently, a group of researchers published a paperin Science, in which they revealed that they had synthesized four new DNA bases, naming the total of eight bases “hachimoji” (which means “eight letters” in Japanese). The synthesis of the four new bases—called S, B, P, and Z—radically changes our understanding of the genetic code and has the potential to transform genetic engineering.
DNA, which stands for deoxyribonucleic acid, is found in every cell and carries the information that determines the growth, development, and everyday functioning of an organism. DNA is a double-stranded molecule, and each strand consists of three components: nitrogen-containing bases (A, T, G, C), sugars, and a phosphate group. The bases of the two strands pair with each other through hydrogen-bonding and determine the identity of the genetic sequence. The main processes that DNA molecules undergo are replication, which allows cells to grow, and transcription, which helps DNA produce the different proteins that it codes for and which are necessary for a cell’s survival.
Replication occurs every time cells divide, since each daughter cell that results from the division must have the same genetic information as the parent cell. This ensures that the identity and normal functioning of each cell is maintained through every division. In transcription, an intermediate RNA molecule is created, which is then used to make proteins for use by the cell. RNA is very close in structure to DNA but the main function of RNA is to temporarily carry the information to make proteins.
The researchers synthesized two additional base pairs: S and B, as well as P and Z. Unlike the natural base pairs, these synthesized bases do not exist in nature. However, P, Z, S, and B have structures that are very similar to A, T, C, and G; they are also nitrogen-containing compounds that have small chemical differences to make them unique molecules. Like A, T, C, and G, they are able to undergo hydrogen-bonding, which is the link that holds bases and entire DNA strands together. The fact that the newly-synthesized base pairs have similar chemical structures and can hydrogen bond, just like the natural bases, indicates that they can behave very similarly.
After synthesis, the new base pairs had to be tested in order to determine whether they could undergo the same processes as natural DNA. The researchers added the synthetic base pairs into a double-stranded molecule that also included A, T, C, and G, and performed a variety of tests on this molecule to determine whether it maintained the characteristic features of natural DNA.
First, a crucial feature of DNA is that its base pairs are complementary and bind with each other through hydrogen bonding. This is necessary for preserving the identity of the genetic sequence and for ensuring that replication and transcription run smoothly. In this new molecule, the normal bonding between base pairs was preserved: A paired with T, and C paired with G, and notably, P paired with Z, and S paired with B. Also, the melting point—the temperature at which the bonds between base pairs break and the strands separate—of the molecule was very similar to that of natural DNA molecules. This important finding showed that the structure and stability of the synthetic base pairs is similar to that of natural DNA.
In addition, DNA is mutable: it can be changed both through natural and experimental mutations. Mutations provide an organism with genetic variation that allows it to adapt to different environments. Although mutations in DNA change the genetic sequence and potentially affect the functioning of a cell, DNA is easily changeable and the act of making mutations does not damage the structure and stability of DNA. As a matter of fact, researchers found that hachimoji that contained mutations were able to maintain the same structure; thus, like DNA, hachimoji is a mutable genetic information system. This feature of the hachimoji is crucial for its potential applications in genetic engineering: being a stable molecule that can withstand breaks and imperfections, it will likely be easily manipulated and inserted into cells.
The authors of the paper also tested whether transcription would occur, which is the process that copies a DNA sequence into an RNA molecule that can be used for protein synthesis. The synthetic DNA was able to undergo transcription, but only if specific RNA polymerases—enzymes that copy normal DNA into RNA in transcription—were present. The ability of this new DNA to make RNA opens up the possibility of developing new proteins, though limited by specific RNA polymerases. Also, the researchers did not test whether the RNA transcribed by the hachimoji would be able to be translated into protein. Nevertheless, the fact that the synthetic base pairs could be transcribed into DNA leads to endless pathways in genetic engineering, as RNA—a precursor to proteins—is often used in genetic engineering as a more direct method of inserting new proteins.
All in all, these researchers have established a new genetic system that can store and transfer genetic information with high stability and mutability. Thus far, this genetic system only exists in a precisely-controlled lab environment. Nevertheless, the authors of the paper emphasized that this finding has a wide variety of potential applications. With double the number of DNA bases as A, C, T, and G, hachimoji DNA has much more diversity and has the potential to make synthetic biology and genetic engineering more powerful. Currently, the number of codons, which make up proteins, is limited by the number of DNA bases at 64 possible codons. With an eight-letter alphabet, however, there are4,096 codons—a change that dramatically increases the number of possible, unique proteins that can be created. Having more possible sequences and proteins, for example, would lift constraints on drugs that need to bind to protein-specific receptors and targets in order to work. Without a doubt, this discovery completely upends the standard approach to research; rather than work within the confines of four base pairs, scientists in a variety of fields can employ this revolutionary discovery in unprecedented ways.
By: Clare Nimura
Can a toddler have anxiety, post-traumatic stress disorder, or depression? We don’t often think about mental health problems afflicting very young children, but about ten percent of preschool-aged children have some form of emotional, behavioral, or relationship conflict. Currently, most young children (<5 years old) with these issues receive no diagnosis or intervention. Left untreated, they suffer long-lasting effects to their social and emotional well-being, including impaired social interactions, parent-child relationships, physical safety, and school readiness. If emotional, behavioral, and relationship problems are so common in young children, and can have such significant negative implications, why are they so often neglected? Moreover, how can we increase access to effective diagnoses?
The symptoms of emotional, behavioral, and relationship problems look very different in young children than in adults, which can make them difficult to recognize. For example, a depressed child might exhibit more irritability than a depressed adult, who might instead show sadness. Additionally, almost all children display these behaviors, though in milder forms. For these reasons, it can be difficult for parents or caregivers to recognize when children are showing signs of poor mental health, such as changes in mood or behavior, intense feelings, or difficulty concentrating. Conversely, healthy children are able to express their emotions and then return to stability without extensive intervention.
Additionally, emotional, behavioral, and relationship problems are difficult to identify in young children because they can be caused by innumerable factors. While some children may have a genetic predispositionto mental health problems, a child’s environment is critically important to the state of their social and emotional well-being. Environmental influences can work both ways: a supportive family can greatly improve a child’s mental health, whereas adverse life experiences can be powerful contributors to poor mental health. These experiences can include exposure to violence, parental depression, and housing or food insecurity, such that children in poverty are at a disproportionately higher risk for mental health issues. According to the CDC, 1 in 5 children living below the federal poverty line have a mental, behavioral, or developmental disorder.
Despite the staggering statistics surrounding early childhood mental health issues, both the general public and the medical field lacks awareness, reflected in the shortage of trained mental health providers; one study found that 43 statesare considered to have a severe shortage of child psychiatrists. For pediatricians not explicitly trained in mental health care, systematic screening surveys can be invaluable tools to identify young children with emotional, behavioral, or relationship problems, as well as children at risk. The only problem is that most surveys are arduous and time consuming. For primary care physicians under pressure from the medical system, extensive surveys can be infeasible; optimally, they would have a simple yet informative survey for their diagnoses.
Mary Margaret Gleason, a pediatrician, child psychiatrist, and graduate of the Columbia University College of Physicians and Surgeons, helped develop one such survey: the Early Childhood Screening Assessment (ESCA). The survey takes just 5 to 7 minutes and is written at a fifth-grade reading level. Parents complete this form in the waiting room, rating 36 items relating to their child’s behaviors on a scale of 0 (never/rarely), 1 (sometimes/somewhat), and 2 (always/almost always). The last 4 items on the survey screen for parental depression or other mental illnesses that could interfere with childcare.
The score determined by the survey can identify emotional, behavioral, or relationship problems and also serves as a risk assessment based on environmental conditions. This quantitative information can flag concerns that might otherwise remain unnoticed in a hurried pediatric physical. And as we know, neglecting to diagnose mental health in very young children can have many negative implications for their future well-being.
Mental health problems in very young children often go undiagnosed. Clearly, diagnosis is not the only factor—effective and sustainable treatment also requires great advancements—but awareness is a very important first step. Surveys like the ESCA can improve diagnosis and treatment for children in areas with limited access to trained mental health professionals. Increasing awareness of the prevalence and long-term implications of mental health problems in young children is essential to ensure that all children have the support they need to develop to their full potential.